CAJ | 학술논문

【目的】探讨经口内镜下肌切开术（POEM ）治疗贲门失弛缓症（AC ）的中长期疗效。【方法】应用POEM治疗133例AC患者，术后定期随访，收集患者一般情况、症状评分、并发症、复发、内镜及钡餐检查等资料。【结果】133例患者均成功完成手术，平均操作时间为58．8 min ，隧道长度平均为13．5 cm ，肌切开长度平均为10．4 cm。术后患者症状明显缓解，Eckardt评分较术前明显降低（6．4 vs 0．5，P ＜0．001）；食管直径较术前显著缩小（59．0mmvs32．4mm，P ＜0．001）；并发症发生率为6．8％（9／133），其中气肿发生率为4．5％（6／133）；平均随访19．3个月，99．2％（132／133）有效，随访期内无一例复发。【结论】POEM 治疗AC可获得满意的中长期疗效，其远期疗效及并发症仍有待于进一步随访评估。
【목적】탐토경구내경하기절개술（POEM ）치료분문실이완증（AC ）적중장기료효。【방법】응용POEM치료133례AC환자，술후정기수방，수집환자일반정황、증상평분、병발증、복발、내경급패찬검사등자료。【결과】133례환자균성공완성수술，평균조작시간위58．8 min ，수도장도평균위13．5 cm ，기절개장도평균위10．4 cm。술후환자증상명현완해，Eckardt평분교술전명현강저（6．4 vs 0．5，P ＜0．001）；식관직경교술전현저축소（59．0mmvs32．4mm，P ＜0．001）；병발증발생솔위6．8％（9／133），기중기종발생솔위4．5％（6／133）；평균수방19．3개월，99．2％（132／133）유효，수방기내무일례복발。【결론】POEM 치료AC가획득만의적중장기료효，기원기료효급병발증잉유대우진일보수방평고。
[Objective] To evaluate the intermediate and long‐term efficacies of peroral endoscopic myoto‐my (POEM) for patients with achalasia .[Methods] A total of 133 patients with achalasia underwent POEM . And the clinical data of Eckardt's score ,complications ,recurrence ,endoscopic examination and esophageal barium radiography were collected before and during regular follow‐ups .[Results] POEM was performed all successfully .The mean operative duration was 58 .8 minutes and the average lengths of tunnel and myotomy were 13 .5 and 10 .4 cm .Symptoms remitted in all of them .Eckardt's score decreased significantly (pre‐ vs post‐treatment ,6 .4 vs 0 .5 ,P<0 .001) .And the diameter of esophageal lumen decreased (pre‐vs post‐treat‐ment ,59 .0 vs 32 .4 mm ,P<0 .001) .The incidence of complications was 6 .8% (9/133) and gas‐related com‐plications had an incidence of 4 .5% (6/133) .Treatment success was achieved in 99 .2% (132/133) with a me‐dian follow‐up period of 19 .3 (12~30) months .There was no recurrence .[Conclusion]POEM has short and intermediate‐term efficacies for achalasia .However its long‐term outcomes require further studies .